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膝关节、髋关节和腰椎的低骨量肌肉质量和放射影像学骨关节炎:一项横断面研究。

Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: a cross-sectional study.

机构信息

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.

出版信息

Aging Clin Exp Res. 2019 Nov;31(11):1557-1562. doi: 10.1007/s40520-018-1108-5. Epub 2019 Jan 7.

Abstract

BACKGROUND

Although several studies have shown that low skeletal muscle mass is correlated with knee osteoarthritis, no studies have investigated the correlation between skeletal muscle mass and hip and lumbar spine osteoarthritis (OA).

AIM

This study aimed to delineate the relationship between low skeletal muscle mass and radiographic OA (ROA) of the knee, hip, and lumbar spine.

METHODS

This is a cross-sectional study using the public data obtained from the Fifth Korean National Health and Nutrition Examination Survey (2010-2011). We included subjects aged ≥ 50 years who completed the surveys (3813 subjects). ROA was assessed by knee, hip, and lumbar spine radiographs and defined as Kellgren/Lawrence (KL) grade of at least 2 in the knee and lumbar spine, whereas KL grade ≥ 1 in the hip. Multivariate logistic regression analyses were performed to evaluate the effects of low skeletal muscle mass on radiographic joint degeneration.

RESULTS

Appendicular skeletal muscle mass (ASM) was higher in subjects with healthy joints than in subjects with knee and lumbar spine ROA (18.9 ± 0.1 kg vs. 17.1 ± 0.2 kg, P < 0.0001 and 18.6 ± 0.1 kg vs. 17.4 ± 0.2 kg, P < 0.0001, respectively), whereas it was higher in those with ROA than in those with healthy hip (17.9 ± 0.1 kg vs. 19.1 ± 0.2 kg P < 0.0001). On multivariate logistic regression analysis, lower skeletal muscle mass independently associated with knee ROA [odds ratio (OR) 1.348; 95% confidence interval (CI) 1.037-1.752]. However, it was inversely associated with lumbar spine ROA (OR 0.786; 95% CI 0.623-0.991).

CONCLUSION

Low skeletal muscle mass was independently associated with knee ROA alone, whereas it was inversely associated with lumbar spine ROA. These opposite results might originate from measuring the area of ASM.

摘要

背景

尽管已有多项研究表明,骨骼肌量减少与膝关节骨关节炎相关,但目前尚无研究探讨骨骼肌量与髋关节和腰椎骨关节炎(OA)之间的关系。

目的

本研究旨在阐明骨骼肌量减少与膝关节、髋关节和腰椎的放射性 OA(ROA)之间的关系。

方法

这是一项使用 2010-2011 年第五次韩国国家健康和营养检查调查(KNHANES V)的公开数据进行的横断面研究。我们纳入了完成调查(3813 例)且年龄≥50 岁的受试者。通过膝关节、髋关节和腰椎 X 线片评估 ROA,并将膝关节和腰椎的 Kellgren/Lawrence(KL)分级≥2 定义为 ROA,而髋关节的 KL 分级≥1 定义为 ROA。采用多变量 logistic 回归分析评估骨骼肌量减少对放射关节退变的影响。

结果

与膝关节和腰椎 ROA 受试者相比,关节健康受试者的四肢骨骼肌量(ASM)更高(18.9±0.1kg 比 17.1±0.2kg,P<0.0001;18.6±0.1kg 比 17.4±0.2kg,P<0.0001),而与髋关节 ROA 受试者相比,关节健康受试者的 ASM 更高(17.9±0.1kg 比 19.1±0.2kg,P<0.0001)。多变量 logistic 回归分析显示,较低的骨骼肌量与膝关节 ROA 独立相关(比值比 1.348;95%置信区间 1.037-1.752)。然而,它与腰椎 ROA 呈负相关(比值比 0.786;95%置信区间 0.623-0.991)。

结论

骨骼肌量减少与膝关节 ROA 独立相关,而与腰椎 ROA 呈负相关。这些相反的结果可能源于 ASM 面积的测量。

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